Quarterly Bulletin

I want to begin by briefly situating my approach within two frameworks:  first, the Jesuit social apostolate mission and second, the socio-economic context of Zambia today.

First, the mission of the Jesuit social apostolate has been made very clear in documents of recent  General Congregations, of letters from Fathers Janssens, Arrupe and Kolvenbach, and in guidelines from the Social Justice Secretariat in Rome. 

This mission is two-fold: (1) to fulfill the Society of Jesus’ general mission of service of faith and promotion of justice in a particular work (e.g., providing shelter, education and legal protection for street children, promoting rural development especially among the poor, conducting economic research in a social centre); and (2) to influence and support the Society’s mission in other specific apostolates of a Province (e.g., cooperating with service programmes in secondary schools, offering socially-oriented pastoral materials to parishes, engaging in formation programmes for young Jesuits).

Thus to speak of Jesuit programmes and activities against AIDS as part of our social apostolate, we must take into account both the specific and the general approaches.

Second, in speaking of the situation in Zambia, it is important to appreciate that Zambia is a very rich country, one of the richest countries in Africa, with very poor people. Zambia is rich in natural resources of land, water, minerals, agriculture, tourist sites and rich in human resources of a people at peace for over forty years of Independence (we are the envy of our neighbours!).  But the Zambians are poor, with most people unable to afford basic needs and with a life expectancy of 37 years.

It is in this paradoxical context of poverty amidst riches (the internal and external causes of which would require another and much longer presentation!) that the issue of AIDS has to be addressed.  Estimates of HIV prevalence in Zambia today range from 16% to 20%  of  the  sexually active, between 15 and 49 years (depending on the source of statistics).   But while this very large number of the population is infected, 100% of the population is affected. 

OPERATIONAL FRAMEWORK

Before looking at the Jesuit response in Zambia, let me offer a framework of different approaches.  These of course may operate separately or in one form or another together.

Immediate prevention: education and sensitisation about the disease, encouragement of ABC steps (abstain, be faithful, use condom), encouragement of VCT (voluntary testing and counseling), reduction of risk situations by dealing with hunger and deprivation.

Immediate and long-term care: improved medical responses, home-based care programmes, counseling and spiritual assistance, provision of ARVs (with attention paid to the necessary tripod of medical testing, nutrition provision and psychological support).

Long term eradication: commitment to a culture of sexual responsibility and an economy of sustainable viability, integral development and eradication of poverty.

So what do Jesuits do in Zambia?  Let me first note what is done in the other country of our Province, Malawi, another poor country facing a serious problem of the pandemic. Father Dick Cremins works in a family-support programme with educational outreach that includes the HIV/AIDS issue.  Mr. Wilfred Sumani, a scholastic, has produced a local language music disk with an AIDS theme.  Our parish in Kasungu and our chaplaincy in schools also take up HIV/AIDS issues. 

Looking only at Zambia, I will describe some general approaches (without pretending to be all-inclusive) and then analyse in detail two specific efforts.

General Approaches

Most of our Jesuit parishes host home-based care (HBC) activities, a growing apostolate that serves especially the poor who are infected.  From my own experience in the outstation of Kabangwe outside Lusaka that I am in charge of, the HBC approach is the graced side of a tragic situation.  Members of the parish small Christian communities learn some basic skills of dealing with very sick and dying patients and voluntarily minister to them with minimal support.  In   a situation of  grossly deficient public and private medical infrastructure, these home-based care teams are indeed a blessed service to individuals and families.  Moreover, because they are community based, they also deal positively with the problems of stigma and exclusion.  

Several of our parishes also have programmes to relate to the growing population of orphans in Zambia. The orphan programmes include activities such as provision of food and assistance with school fees. 

Spiritual help for both those infected and those affected is offered in a variety of ways.  One recently-deceased (April 2005) Jesuit, Father Bob Kelly, wrote two widely read and greatly  appreciated  books of spiritual resources for those suffering from HIV/AIDS and those ministering to them.  Often the special needs of people in the latter category –e.g., family members, medical agents – are neglected in our responses.  The chaplain at the main government hospital in Lusaka is a Jesuit, Father Jack Doyle, and he has been particularly vocal on the need to promote VCTs in order to help people know their status and live accordingly.

In Zambia, we Jesuits are involved in secondary education in two schools and also serve in several tertiary institutions.  These educational institutions offer a variety of inputs to students about the AIDS challenge.  For example, two prominent women doctors addressed students at gatherings organised by Jesuit chaplains, one at the major university and the other at a teachers’ training college.   Both inputs strongly challenged young people to live in a more responsible and life-giving way.  We do need to ask, however, whether the ordinary curriculum in our schools adequately reflects input on the HIV/AIDS pandemic.

A Jesuit medical doctor, Ken Johnson, serves in a government hospital in the southern part of Zambia.  Speaking from experience, he has emphasised that AIDS is but one of several life-threatening medical challenges that the poor face in every-day life and that we should pay attention to.  (Think of malaria, malnutrition, accidents.)  Johnson rightly cautions that we should not let an AIDS focus distract or destroy basic health care needs.

Communications is a key activity that is enlisted in the fight against AIDS.  Father Charles Chilinda directs Loyola Productions, a television office in Lusaka, and is preparing an educational video on AIDS.  Radio Chikuni, a Jesuit parish-based community radio station in a rural area of southern Zambia, daily broadcasts educational programmes that inform and motivate people regarding both prevention and care in the face of the HIV/AIDS challenge.

The formation of young Jesuits is key to future responses by the Society in Zambia.  Because of the fact that most African Jesuits have first-hand awareness of the reality of HIV/AIDS from the experience of family and friends, relating to this issue is not foreign.  In the Lusaka novitiate, hospital experiences (“experiments”) immediately expose the young to the HIV/AIDS situations of sickness, stigma, abandonment, death, family reactions and medical deficiencies. 

One other Jesuit response should be noted, though the Jesuit originally active in the project is no longer involved.  Father Michael T. Kelly, a trained psychologist, established KARA Counseling Centre in the late 1980s in Lusaka.  This was the first institution in the country to publicly address the need for testing and counseling and to provide widespread education about HIV/AIDS.  M.T. Kelly’s contribution remains significant because KARA continues today to be an influential and valuable service in Zambia.

Specific Efforts

Research and Education

Jesuit activities against AIDS in Zambia are today often associated with the name of Father Michael J. Kelly.  An educationist with a long and distinguished career at the University of Zambia (UNZA), he has been in the forefront of research on the interconnection between education and HIV/AIDS.  His research in Zambia and in other parts of Africa and in the Caribbean has highlighted the negative impact on education of the spread of HIV.  Loss of teachers and diversion of resources are two obvious effects. 

In Zambia and elsewhere, the quality and quantity of education available to the youth is terribly affected by the HIV/AIDS pandemic and this has immense consequences on both present and future development possibilities.  Unless this fact is paid attention to in effective policy, national progress simply cannot occur.

But Kelly has also demonstrated the positive impact of education itself on the spread of the disease.  And it is not simply education about AIDS but simply any education at all that can make a difference.  His research findings – widely distributed through meetings, articles and books – demonstrate that the more education is available, the less HIV is present. In a recent JCTR Bulletin, he writes,

It seems that it was the fact of being through school that made the difference and not education about HIV or AIDS as such.  [For example, in Zambia it has been found that] …a girl who dropped out of school was three times more likely to be HIV- positive than her age-mate who remained in school. What seems to be happening is that school education somehow opens a person up to taking in and acting on information from other sources, including information about the disease and how to protect oneself against it….On every measure that has been taken, those with primary education come out better than those with no education, those with secondary better than those with primary, and those with tertiary better than those with secondary. Clearly education counts, and the difference is more than in knowledge, since being educated is linked with going for HIV testing, something that requires action.

Kelly has focused particular attention on the girl child and her opportunities for schooling, having done specific research for UNICEF on this topic.  And he writes and speaks passionately about the increasing “feminization of HIV/AIDS,” the fact that women increasingly suffer from the spread of the pandemic, both as being infected and as being the primary care-givers of those infected. 

Because of his clear and cogent manner of presentations, he is much in demand as a speaker, both for church groups and secular organisations. He has not been  shy  to  offer  audiences the best of recent moral theological reflection on the use of the condom.  While in no way speaking simplistically about the condom as 100% safe protection against HIV infection, he also does not speak simplistically about total rejection of its use.

In my view, Father Kelly’s role in the fight against AIDS has been an excellent – indeed, an inspiring – example of the best of Jesuit contribution to a complex subject: scholarship coupled with compassion and courage.

Sensitisation and Advocacy

The Jesuit Centre for Theological Reflection (JCTR) is a faith-based organisation engaged in research, education, advocacy and consultation on social justice issues in Zambia and Malawi.  The JCTR is widely known and respected for its focus on issues of economic development, debt cancellation, cost of living, political responsibility, and north-south relationships.  It is a major promoter of the value methodology of the church’s social teaching (CST) and its relevance to public policy debates and decisions.

The JCTR does not have a specific AIDS project or an explicit overriding orientation toward this topic.  Of course, in all its activities for almost 20 years, the JCTR has not ignored the challenge of AIDS – it could not!  But about three years ago, we adopted an explicit three-fold approach that merits attention in our discussion here. 

First, our Centre staff committed ourselves to an on-going process of personal sensitisation about HIV/AIDS.  This has involved a two-day retreat with outside facilitators and occasional input by outside experts.  These experts have included Michael J. Kelly, Michael Czerny, coordinator of the African Jesuit Aids Network (AJAN), and Dr. Simon Mphuka from the Churches Health Association of Zambia.  Frank and probing discussion among staff have heightened awareness and deepened sensitivity and promoted a willingness to undergo VCT. 

Second, a survey was undertaken by a commissioned consultant to see whether or not the JCTR lived up to its express desire to “mainstream” the HIV/AIDS issue by “crosscutting” the issue through all we do.  The consultant studied all of our printed materials, analysed our strategic plans and interviewed our staff.  She concluded that while we do indeed raise the issue frequently, we have more to do in order to substantively and effectively integrate the issue into our thinking and communicating. 

The third step in the JCTR approach is to develop an in-house policy for staff members who may be infected.  This step is still in a very early stage of consulting with groups similar to us (e.g., the Catholic Secretariat and Catholic Relief Services) to see   what can be learned   from their policies and experiences, e.g., for provision of medical assistance, including ARVs.

Some examples of how JCTR projects have related to the HIV/AIDS challenge include the following:

Our Jubilee-Zambia campaign for total cancellation of external debt links  he  diversion of scarce resources to service the external debt to the lack of adequate educational and health services provided for a very poor population.  Poverty is seen not only as a consequence of AIDS but also as a cause. 

Advocacy efforts around the design and implementation of the Zambian Government’s Poverty Reduction Strategy Paper (PRSP) have included a concern about the integration of HIV/AIDS policy into overall poverty plans.

Our monthly survey of the cost of living, the JCTR Basic Needs Basket, has highlighted the need for household food security to be factored into any programme of distribution of ARVs.  Without regular access to adequate nutrition, a person on ARVs risks toxic consequences.

The quarterly JCTR Bulletin regularly carries articles about HIV/AIDS.  One recent article noted the  disparity  in  care-giving along gender lines: women minister to people dying; m­en busy themselves with burying the dead!

Dealing with HIV/AIDS raises many social justice questions (e.g., discrimination, access to medicines, religious responses, accuracy of statistics, etc.).  The JCTR will in the near future commission a major research study on various aspects of justice and AIDS.

There are many cultural dimensions to the HIV/AIDS problem and response.  Our JCTR Task Force on Inculturation has recently published an educational resource for small Christian communities that deals with traditional healing, a topic with much relevance, both positive and negative, to the pandemic. 

Our project to promote awareness and implementation of the church’s social teaching (CST) – something that is all too often “our best kept secret”! – emphasises the public policy values of solidarity and accountability  and  the private life values of responsibility and compassion that are so necessary for effective responses to the HIV/AIDS challenge.  We also share what local Bishops have said about AIDS and highlight the topic in the publication of our annual CST calendar.

Shortcomings

This brief review of Jesuit programmes and activities against AIDS in Zambia would be incomplete without noting some of the shortcomings or limitations of our responses.  I mention only three.  First, we are probably not doing enough to deal with the immense crisis of orphans in our nation.  Economic problems and cultural changes have devastated the traditional response structure of the extended family.  A future generation of adults who have grown up without ordinary parental care and instruction are a weak foundation for national progress and prosperity.  Whether or not we Jesuits are doing enough, by ourselves or in cooperation with others, to respond  to   this  crisis  is  a  very
serious challenge that the Province is considering.

Second, there is need for greater moral and ethical teaching on this topic of HIV/AIDS. Promotion of responsible sexual behaviour should include drawing on traditional cultural values that can be supportive of abstinence and fidelity.  We should be more forthright in challenging the cultural imperialism of westernisation – indeed, Americanisation – brought in through television, movies, music and clothes that undermine good community and personal values.  We also should be more honest in speaking about condoms, so that a critical voice rejecting a “condomisation” promoting promiscuity does not drown out a responsible voice recognising the instances where condoms would be morally acceptable and required (e.g., as self-protection within marriages).

Third, we need to ask ourselves whether we are doing enough to form present and future Jesuit ministers who can respond effectively to the multiple challenges raised by the spread of HIV/AIDS.  The fabric of Zambian social life in every aspect is threatened by among other factors AIDS.  Is this fact influencing the spiritual, intellectual and practical training of Jesuits -- initial and on-going formation?  I know that the occasional focus on HIV/AIDS during our periodic Province Assemblies is considered helpful but not sufficient.  What more can we do?

Conclusion
Grounds for Hope

It is clear that the programmes and activities of the Jesuits in Zambia against AIDS are in line with the mission of the social apostolate of the Society of Jesus.  Both general apostolic efforts and the specific efforts of particular persons and works serve the faith and promote justice in meeting this serious challenge that especially affects the poor.  I believe that even the brief overview offered here demonstrates a commitment to respond to the invitation of Christ the King in the Spiritual Exercises of St. Ignatius – “laborare mecum” – in the building of a Kingdom of fuller life. 

Our Jesuit work is, of course, the work of the Church, with and for the Church.  As such it is directed by the Social Teaching of the Church.  For me, the four major principles of that social teaching have immense relevance for the struggle to prevent the spread of AIDS, to care for those infected and affected by AIDS, and to eradicate the scourge of AIDS itself.  These are the principles of (1) the dignity of the human person, with rights and duties, (2) the centrality of community, (3) the priority of concern for the poor, and (4) the integrity of creation.  If these principles guide our  work, we can be confident it is the work of the Kingdom.

But I believe that the social teaching offers something else very important now for our Jesuit work.  That is hope.  Recently, a person who I know is deeply committed, at personal sacrifice, to serving the poor and the vulnerable in our Zambian society told me something that disturbed me profoundly.  He said he felt that Zambia really had no future for integral human development because the devastation of AIDS was simply not going to be stopped.  The fundamental behavioural change required was too great, too contrary to habits personally entrenched and to environment structurally reinforced.  We should do whatever we can do, he said, but only with the realisation that it ultimately was futile.

I cannot judge his observation true or false, but it is not mine.  Because I rely heavily on a powerfully motivating statement from the social teaching:  “the future belongs to those who can give hope to the present”.  I am committed to giving that hope in the struggle against AIDS in Zambia, and I believe that our Jesuit social apostolate can give and is giving that hope in the several efforts sketched out in this paper.  And that gives me more hope.  I believe it can and will give a future for Zambia.

Pete Henriot, S.J.
JCTR Staff
Lusaka